Individual provider Active NPI

Dyanna Marie Harrison, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Glendale, AZ
National Provider Identifier
1982089215
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP8002 Issued in AZ
Practice address
5555 W Thunderbird Rd
Glendale, AZ 85306-4622
Phone
(602) 865-5501
NPI assigned
Jul 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP8002 AZ Primary
Nurse Practitioner 363L00000X AP8002 AZ

Addresses

Primary practice location

5555 W Thunderbird Rd
Glendale, AZ 85306-4622

Mailing address

9807 E Larkspur Dr
Scottsdale, AZ 85260-5145
Phone (480) 330-2109

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151023000760 AZ Practitioner - Nurse Practitioner 3173832656 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP8002AZMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America- Arizona, PC CurrentSince Aug 1, 2023 Accepting new patients
North Valley Emergency Specialists CurrentSince Sep 15, 2015 Accepting new patients
Progressive Medical Associates PLLC Nurse Practitioner CurrentSince Dec 1, 2019 Accepting new patients
Cep America - Arizona PC CurrentSince Aug 1, 2023 Accepting new patients

Locations

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

10146 E Old Vail Rd
Tucson, AZ 85747
Phone (520) 229-2657

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1982089215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9807 E LARKSPUR DR",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852605145",
            "telephone_number": "480-330-2109",
            "fax_number": "480-968-2254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 W THUNDERBIRD RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064622",
            "telephone_number": "602-865-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "DYANNA",
        "middle_name": "MARIE",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-28",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "AP8002",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP8002",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.